Read Provider Update
This monthly newsletter delivers updates on policies, changes to benefits, and other news you need to know.
- P = Professional
- B = Behavioral health
- F = Facilities
A Word from our Medical Directors
P B F
1 Mar, 2023
Gonzalo Paz-Soldán, M.D., CPE is BCBSRI’s senior medical director for clinical transformation. Dr. P...
P B F
1 Fev, 2023
Matthew Collins, M.D., M.B.A. is BCBSRI’s executive vice president and chief medical officer, with...
P B F
1 Jan, 2023
Matthew Collins, M.D., M.B.A. is BCBSRI’s executive vice president and chief medical officer, with c...
BCBSRI Update
F
14 Mar, 2023
Effective 1 de abril, 2023 BCBSRI will resume prior authorization requirements for Skilled Nursing admi...
P B F
1 Mar, 2023
Healthcare should work for all of us. At BCBSRI, we believe that getting to know our members better—...
P B F
1 Mar, 2023
The United States Department of Health and Human Services (HHS) declared a public health emergency (...
Provider Relations
P B F
1 Mar, 2023
Effective 1 de janeiro, 2023, all existing and new BlueRI for Duals (D-SNP) members received new ID car...
P B F
1 Fev, 2023
BCBSRI encourages its participating providers to collaborate with us in supporting the LGBTQ communi...
P B F
1 Jan, 2023
As a reminder, the prefix for State of Rhode Island employees is R2I (R 2 and the letter “I"). We ha...
Physician & Provider Call Center
P B F
1 Jun, 2021
Did you know our secured Physician and Provider Portal offers the following: •Check member benef...
Quality
P
1 Mar, 2023
Measure description: The percentage of women 16-24 years of age who were identified as sexually acti...
P
1 Fev, 2023
Key measure updates: Colorectal cancer screening will widen its age range to 45-75 years of age to ...
P
1 Dez, 2022
This year, the CDC is observing National Influenza Vaccination Week from 5 de dezembro-9. This month’s ...
Behavioral Health
B
1 Mar, 2023
What is NSSI? Non-suicidal self-injury (NSSI) is a behavior in which an individual inflicts physic...
B
1 Mar, 2023
BCBSRI’s Supervisory Protocol has been expanded to include Mental Health Counselor Associates and Ma...
B
9 Fev, 2023
BCBSRI’s Supervisory Protocol has been expanded to include Mental Health Counselor Associates and Ma...
Farmácia
P F
1 Mar, 2023
For NEHP members with a RI PCP, inquiries regarding medical drugs should be directed to the member’s...
P F
6 Fev, 2023
For NEHP members with a RI PCP, inquiries regarding medical drugs should be directed to the member’s...
P B F
1 Jan, 2023
The Inflation Reduction Act (IRA) will take effect on 1 de janeiro, 2023.The Act includes the following...
Products & Benefits
P B F
1 Dez, 2019
In the large group portfolio, we will also be adding eight Network Blue New England Options plans, a...
P B F
1 Dez, 2019
Our regional BlueCHiP family is expanding in the small group market with Effective 1 de janeiro, 2020, ...
P B F
1 Dez, 2019
Effective 1 de janeiro, 2020, BCBSRI will become the insurer for all Lifespan employees. Below is a qui...
Reivindicações
P B F
1 Jan, 2023
As a reminder when sending medical records to BCBSRI, a valid coversheet should be placed on top of ...
P B F
16 Mar, 2022
**This update will not take place this weekend and it will be rescheduled to a future date. ** B...
P B F
7 Jan, 2022
BCBSRI will be implementing changes to bluegateway.bcbsri.com and the system was supposed to be unav...
Policies
P F
1 Mar, 2023
We have completed our review of the 20 de abril23 CPT code changes, including any category II performan...
P F
1 Mar, 2023
Orthognathic Surgery Effective 1 de maio, 2023, these services will now be medically necessar...
P B F
1 Mar, 2023
The following policies were recently reviewed for annual update. The full texts of these policies ar...